特殊孩子的平常事

LittleKoala

儿子的大便训练一直没有进展，主要原因是他没有规律，有时一天一次，有时几天一次，追根溯源，可能问题还在饮食上，一时半会也没什么高招。昨天晚上我们的一个疏忽，造成了一个比较大损失的accident，让我们很是扫兴和沮丧，下狠心要抓紧训练的步伐。

今天，儿子在几件小事上又让我们高兴了一下：
1， 开始吃面包了，而且吃我们自己做的小三明治：两片小面包抹上cheese或者别的果酱。2，今天居然和妈妈抢黄瓜吃，后来专门给他切了些，居然就开吃了。3，自己可以完全自主拿杯子喝水了。

儿子在1岁半以前，是什么都吃的，要不他也不会发育得那么好，比同龄的小鬼子还高还重。可从那以后，病一次，胃口退一步，两岁半以后是以加速度后退，去年有一周多的时间一度只吃麦当劳的薯条。现在是一点点一步步收复失地，我们心里还是很高兴的。

说起来，这些生活小事其实是最烦人的，点滴进步也能减轻不少负担，也适时地增强了我们的信心。

女儿是天使

下面引用由[U]LittleKoala[/U]发表的内容：

点滴进步也能减轻不少负担，也适时地增强了我们的信心。...

这就是大进步！今天还跟鱼妈说呢，进步，在我看来，就是跟孩子的相处变得越来越容易！

melon

考拉妈妈，看到你们找到人帮手，我好像都感觉轻松一点似的。我们这边的大学这个星期春假，甜瓜的老师都出去玩了，我没了帮手，觉得还是压力大不少。好在最近天气不错，又暖和，孩子们昨天在外面骑车什么的，玩的很高兴。

关于大便，的确比小便要困难不少。甜瓜是３岁整学会小便上厕所，４岁多一点点才彻底自己上厕所大便的。他的困难在于不习惯坐着等待，而是有他自己一套‘办法’。我们后来有经验了，看他坐卧不安，跑几步再跳两下，就知道他要大号了。这个时候赶快动员他去坐马桶。刚开始肯定是不干的，不过多试几次他慢慢就习惯了。再有就是你说的给他多吃香蕉之类的水果，也促进肠胃蠕动。一旦在马桶上大号成功，马上连表扬带奖励，让他有成就感。总之是家长要眼勤（观察），手勤（时机成熟马上去洗手间），嘴勤（检查督促表扬）。是个累活儿，不过成功了你就觉得省很多事情。

lsqsmz

桥桥为了大便顺畅，也是每天一根香蕉的。

LittleKoala

谢谢嘟嘟妈和melon妈妈的鼓励，更谢谢melon妈妈和桥桥爸爸的高招。

儿子以前每天吃香蕉，后来就没兴趣了，现在尚在收复失地阶段，偶尔吃一根，算是赏脸。目前，倒是每天至少一个牛油果，还不坏。

下面引用由melon发表的内容：
总之是家长要眼勤（观察），手勤（时机成熟马上去洗手间），嘴勤（检查督促表扬）。是个累活儿，不过成功了你就觉得省很多事情。

melon妈妈这条总结最好，我们是人手不够，该注意的时候（一般是晚饭后）就很累了，有时一松懈，一懒惰，就要出问题了。不过要努力这么做，问题早解决早好。

方静

我们家自从买了九阳豆浆机后，每个人的DB都顺畅了。我想这是粗粮的果效，喝的时候我们干脆不去渣渣，都喝了的。
问题是在澳洲，是不是有困难？

LittleKoala

谢谢方老师，我们有九阳豆浆机，两个大人很享受，就是小人还没发展出兴趣，得往这个方向努力。

lsqsmz

考拉娘，俺是桥妈啊！想想桥爸比俺出道晚多了，可是好几位资深家长都把俺当成桥爸。唉.....一家人，不跟他争了。

方老师说的粗粮豆浆，确实很好的，桥桥也很享用，连渣滓都不留，这也是慢慢来的。想想桥桥曾经吃新东西，也很抗拒。我们经常在他不在意的时候塞进嘴里，只要味道尚可，他也就慢慢接受了。
其实饮食一定程度上是习惯问题，为什么我们总是想家乡的菜，爹娘的厨艺？对于考拉，试着让他开始喝一点，慢慢增多，或者最好掺入一点他喜欢的口味。如果考拉喜欢甜，加点糖；喜欢果汁味，兑一点；还有坚果类也可以与豆浆一起做的。
还想说口腔的问题，日久见效果。最简单的就是将手洗净，食指和大拇指按摩腮部，牙龈，上下颌，揪揪嘴唇，把按摩当成亲子游戏也不错啊。

在这块地学了很多，冒泡反馈点东东。

语晨313

下面引用由[U]方静[/U]发表的内容：

我们家自从买了九阳豆浆机后，每个人的DB都顺畅了。我想这是粗粮的果效，喝的时候我们干脆不去渣渣，都喝了的。
问题是在澳洲，是不是有困难？

方姐你真逗.

LittleKoala

最近很忙，没功夫更新贴子，多谢kwenma2的关心！

这两年的3月，儿子的状态都不算很好，主要是睡眠和情绪问题，可能与这里的天气变化相关，总是热一天冷一天，大人也觉得不舒服。饮食方面有一点进步，愿意尝试和吃新的食物，选择面宽了一些。

儿子训练的第二年进步明显慢了下来，主要原因是训练强度的大大下降，有时近乎放羊，这一点我们认识到了，也采取措施弥补。但是还有一点让我疑惑了很久，最近看Greenspan的文章似乎有了点感觉。

我主要的困惑是，经过训练儿子在某些方面进步是很明显的，例如目光对视很好很自然；与人最基本的互动很好（仅限于见面和告别）；共同关注也很好，可以跟随大人的手指的方向，有时甚至是目光的方向；学术方面的认知进步很快等等...缺陷就不用说了，从一开始我们的关注就是语言，现在还是。已经开口半年多了，进步有一点，但是以蜗牛的速度前进。看了不少书，都说他的这些进步预示将来语言和社交的进步，可左等右等就是没看出来。也许我们的训练有的地方做得不对？

最近看到老格的一段话，讲在他总结的儿童情感发育六阶段中，“Each one of these stages involves a new organization of affect – i.e., affective transformations – which are brought about by specific kinds of emotional experiences. According to this model, mastery of a given stage is a prerequisite for but does not in itself ensure mastery of the next; for at each new stage of development a child must undergo a new range of emotional experiences in order to master the next affective transformation”。按他的说法，儿童情感发育六阶段，必须有前一阶段的基础才能有下一阶段的进步，可有了前一阶段的进步，并不保证下一阶段的进步。

也许，这部分反映了我们的问题。花了很多功夫，打好了前一阶段的基础，一直寄希望于他自己的进步；但我现在认识到，他后面的进步也需要象前一阶段的有意识的训练和积累。恐怕什么时候他能进步到第六阶段，才有可能是他自己向前进步的时候。

一点感想，欢迎有经验的朋友贡献。

binfeng2000

男孩子的语言基本发育状况就是那种憋了很久,终于水漫决堤,一下子冲了出来的那种,在他积蓄能力和水量的时候,只要看看你对你的引导有没有反应,有了就象你说的那样的表现的话,至少心里就有底了,剩下的时间还是很大程度上靠"等字诀".

niuniuma

“at each new stage of development a child must undergo a new range of emotional experiences in order to master the next affective transformation”我最没有经验，关于说话。但是我觉得上面这句话最重要，“要一个新的情感段带”：如果是我，一方面会继续加强认知的训练，读简单的故事书，一页就以两个词的。认字，写字，并知道其含义的。。。 （因为对于我的孩子，认知方面曾不太顺利，语言不丰富和不理解都曾是因为认知跟不上）。另一方面要考虑什么样的情感段带可以带动语言呢？应该是需要表达自己的基本需要最直接吧。是不是应该对他的生活起居不要照顾得太周到，让他“必须”要说话才能达到。
越写越心虚，我根本就没半点经验啊！但愿能抛砖引玉。

宝贝贝

how is koala's current language level? how many words does he know? any combination of two words or more? What do you feel is his difficulty?

My son has problems with longer syllables, even immitation. how is koala's? any problem with immitation, or has trouble with understanding?

Ean妈妈

看小考拉妈妈急也跟着急，可是要说支招吧，又有点班门弄斧的感觉，我还很认同niuniuma说的“生活起居不要照顾得太周到，让他“必须”要说话才能达到。
”的方法，我们有时吃饭都不叫Ean，等他看到所有人都在吃饭了，就跑过来用懊恼的口吻说：“Ean eat”，我们才焕然大悟的说：”ou，Ean is hungry！
”

LittleKoala

谢谢各位朋友！托冯版的吉言，继续等下去。

niuniuma和Ean妈妈说得有道理，我们有时可能是服务得太全面了。

宝贝妈，小考拉差不多，单字有一些，句子有几句，同时还有不会发音的音节，如“g”，“k”，“c”，“x”等。用Lovaas的语言训练方法，曾经管用过一段，但最近对ABA是刀枪不入，早就不要食物鼓励了，对精神鼓励是已经疲惫，对批评倒是很敏感。

问题可能源于我们自己的松懈，不能始终做到前后一致，还有就是表扬太多，失去功效了。所以前两天把QBB写的“日常生活中容易犯的错误”贴子找出来，再仔细看看，好好总结改进一下。

儿子的水平在level 4，level1-3是没有问题的，level 4也不错，但没再上过台阶。自己的检讨是，光注意打基础了，没有及时提升。就是说“跟随孩子的引导”做到了，但多数时候没有抓住机会向上提高。

蜜橙妈妈

从考拉妈妈这里拔了不少人参，冒个泡。考拉被照顾的周到及“早就不要食物鼓励了，对精神鼓励是已经疲惫，对批评倒是很敏感”和我们的橙子很类似，感谢考拉妈妈的总结。

jtbb

格老的书， 我以前也看。自从他哥哥炮制出经济危机，不看了，说不上来为什么，..., I just hate him.

我觉得单纯的音节训练可以多练练，发不出的音， 有人喜欢从口腔肌肉去分析，我觉得归根到底是动力不够。食物鼓励没什么不好，该用时就是要用， 形式可以是promise, 不要贿赂：孩子，我们先练两页发音， 然后是snack time, 想吃什么，说。

我的半分钱。

kwenma2

转贴，可能对你有帮助。

前语言沟通（摘自 自闭儿教养宝典）

  对于协助“自闭症相关障碍”儿童的任何一个人来说，“沟通”都绝对是最关键的部分。一旦孩子会注意到照顾者，冷静且可以调节自己，同时越来越投入在共享的世界当中，这时就是他可以学习有意义沟通的关键时刻了！虽然沟通常被视为是话语的交换（“我饿了”、“给我那个玩具”或“出去”），但它始于前语言层次，使用一些表情动作，就像孩子拿起自己想要的玩具，或发出声音以回应别人的声音。这个能力开始于生命最早的时期，首先是轻轻的点头动作、微笑以及呵呵声，最后则剧增到交换声音、表情动作、微笑及皱眉动作的丰富对话——所有这些都发生于出现任何有意义的话语之前。
    即使在两岁阶段开始会说话之际，这种姿势语言或相互的示意能力，也会比语言交流能力的发展更快速且更复杂，口语能力常需要一段时间才能赶得上；即使在孩子已经开始会说话之后，或甚至大人在说话之际，前语言或表情动作的能力也都同时继续不断发展。人们习惯使用脸部表情、声调、肢体动作等方式来与人沟通。
    其实，大部分的人对于前语言层次信息的信任程度会高于语言层次信息。如果有个陌生人很客气地跟你说：“我需要一点帮助来了解这张地图，请你过来这里?”不过他的脸部表情、肢体动作以及整个氛围都透露着危险，这时你可能会快速走开。你可能会疏忽这个情况的语言部分，并且专注在肢体动作的部分。我们在评估政治人物候选人时，常会留意他们说话的声调、态度以及谈吐的内容；因此表情动作是生命早期所使用的一种基本沟通工具，并且终身都会继续使用。
    孩子所需要的口语技能就建基于此一前语言层次。为了能够赋予话语有特定意义、为了让孩子学会说话且顺利使用语言，首先他们需要精熟使用表情动作与人沟通的能力。即使孩子已经会说话，还是需要有人协助前语言层次的部分（“自闭症相关障碍”儿童更是特别需要协助）。精熟前语言层次，不只对于建立沟通能力有重大意义，同时也是发展社会及情绪能力的关键。孩子若是不能解读及回应社会性信号（譬如：脸部表情、表情动作、肢体动作等），他就难以知道该做些什么或什么时候该做。早在孩子还没学会说话之前，照顾者就会藉着眼神、声音、声调或手势等方式，让他们了解哪些事情具有危险性或安全无疑。所以，孩子想要将手指放进插座时，他会强烈感觉到这是一个不被许可的禁忌，因为他从妈妈声音当中的警告口气、脸上的紧张表情、远离插座的指示动作、急速被抱起并带离危险处等信号，体会到“不可以”这个词语的意义。
    同样地，透过表情和声调也可以传递温暖及爱的感觉。孩子给妈妈一个开心的笑容、做出撒娇表情、伸出手臂要抱抱，妈妈也回以一个开心的笑容、伸出手，并且用温和的声音说“我爱你”。虽然孩子还不能理解“爱”这个字，但是透过妈妈的姿势表情和温暖的声调就能将爱意传回给孩子。因此，孩子无论是学习受约束的范围或了解爱的意思，全都是透过前语言系统来学习。此外，有关社交和情绪能力，以及解读游戏场中其他孩子社会性示意等能力的学习，开始时也都是透过表情动作的沟通。
    接下来，孩子又是如何学习了解各种词语的意思?上面提到的例子，孩子把手伸向妈妈、被抱起来、紧紧拥抱、亲吻、得到慰藉；统整所有这些持续进行的互动内容，让孩子学习到“爱”这个字的意义（通常是在十八个月到两岁半这个阶段）。若是没有这些动作的交流，孩子就无法理解“爱”这个字的意义。他可能被告知并记住这个字的定义，不过却感受不到它的意义，因此也无法领略到它真正的涵义！
    同样地，孩子要学习“苹果”这个辞汇，等他吃过苹果并且把玩过后，就能大致认识了“苹果”。“苹果”对他开始有了意义，它不再只是字典上所描述的：“一个红色且圆形的东西”。因此，一个词汇是否能成为孩子已经知道的标签，主要建基于他还没学会说话之前，与外在世界之间的互动经验。孩子在表情动作层次的沟通能力若已经迟缓，可以在日后透过结合语言层次和表情动作层次的多重互动方式学习，并在精熟这些词语之后再善加利用。

kwenma2

昨天太忙，没有来得急过来（奶奶上周有点轻微的脑溢血，导致右腿最开始不能动了。这两天好多了，但是我昨天得带她去看医生和理疗。晚上又去参加一个ＢＲＡＩＮ　ＧＹＭ的讲座，看看有没有可以借鉴的理论来通过更优化的运动来带动大脑发育。所以晚上１０点才回家）。

首先你觉得小考拉的３－４ ＬＥＶＥＬ已经ＯＫ了。你是指ＤＩＲ／ＦＬＯＯＲＴＩＭＥ的３－４　ＬＥＶＥＬ吗？如果是，那么在３－４ ＬＥＶＥＬ的各个要点是否都牢固了呢？我以前有个帖子是格林斯潘的６个阶段的详细要点，回头我转贴在这里。我们地板时光师就是按照那里的要点一点一点的过滤来看小子还有什么问题。因为低层的基础没有打好，影响上层的建筑。还有就是他一次连续的交流跟你能够到达多少回合呢？注意是连续的交流。回合数的多少还是很重要的，否则他就不能维持跟你的持续互动。当然你总结得对，就是在做３，４ ＬＥＶＥＬ时，你也需要把高一点，逐渐引入第５ ＬＥＶＥＬ。我们小子目前主要做５，６ ＬＥＶＥＬ，但是第４ ＬＥＶＥＬ还不牢固。同时第１，２ ＬＥＶＥＬ中还有很多也得做。目前我开始给他拔高加入７，８，９ ＬＥＶＥＬ的一些概念了。

如果上面的都ＯＫ了（ＬＥＶＥＬ ３是双向交流，ＬＥＶＥＬ4 是解决问题的能力），那么按照道理说他应该开口的。那么他不开口，跟他的口腔肌肉ＯＲＡＬ　ＭＯＴＯＲ有没有关系呢？他比较偏食，他的口腔触觉一般来说会比较敏感，那么他的咀嚼方面会不会落后呢？他的咀嚼的方式正确吗？这些可能都跟他的口腔肌肉和正确运作有关系。有没有语言师那里去评估一下，让他们看看是有哪方面的问题呢？对口腔肌肉的评估，有专门的ＯＴ是专攻ＦＥＥＤＩＮＧ（吃饭吞咽）方面的，是否也可以咨询一下呢？

说到食物奖励和表扬不太起作用了，是因为这些激发不起他的兴趣了。有没有可能发掘一下他哪些方面感兴趣，以此作为奖励的措施？估计你们已经这样做了。可能你们会说他没有多少东西感兴趣啊？我回想以前，我们小子也是这样，我觉得他真的没有多少感兴趣的东西，或者兴趣不大，那时我好着急。如果你们很难找到他感兴趣的东西，就要细心观察，即使他对一些东西你觉得是无意义的玩耍，你如果抓住了，也能把他变为互动。在多次的互动中加入变化，就像滚铁环一样，一环扣一环，最后在他的兴趣点上扩展到另外一个兴趣；再下次又再第二个兴趣点上面扩展到第三个兴趣点，如此以往，这个过程要慢，快了他就抓不住。一段时间下来，他会积累一些兴趣点，变成了一条线的兴趣点。这样你就可以用这些新的兴趣点继续扩充，一条线的兴趣点从这里就可能发散扩展成了许多类似小岛的兴趣点。当他的第６个ＬＥＶＥＬ逻辑思考开始了，那些小岛会慢慢开始变成大岛，最后实现链接。那么最关键的是如何最开始的兴趣点的扩充。按照我自己的经验那就是要慢，缓缓过渡，慢慢引入变化，让他没有感觉多大多突然的变化，还是顺着他的兴趣点或者以他感兴趣的东西作为媒介，但是很多个回合下来，你的多次引入的变化已经把整个格局变得面目全非了（当然是让他中计了，成了你想要的局面）。下面那个老格的帖子也说明了这个思路。

如同上面家长说的随时随地生活中有意设置一些障碍，这个也就能够造就很多互动的机会。比如吃饭是，他坐在椅子上了，但是你有意让椅子和桌子离得远，看他怎么做？看他需要你的帮助吗？看他有没有身体姿势交流？还是有说话。这个时候他的动机就非常明显了。如果你觉察出来他没有动机，你就多给他时间，等等看他干什么？如果实在他没有任何表示，那你可以提供两项选择让他选（注意一个是正确答案，一个是非常ＳＩＬＬＹ的答案）；如果还不知道，可以评论说“太远了”等等，让他知道；如果他有表示，只是说不出来，你可以评论，说一部分或者加示范（ＭＯＤＥＬＩＮＧ） 等等。然后因为问题是椅子和桌子太远了，那怎么办？又可以有很多回合的。如果说得出结论要“挪近”椅子，那接下来更多的回合会出现：你可以问他是挪近一点点吗？挪近一点点后，肯定还不够，那你又可以逗他是再挪进“大拇指”这么一点点还是一条缝缝那么一点点，或者大一点，这么长，还是那么宽，等等，随便你去发挥。也可以在移动椅子时直线移动，曲线移动，左移，右移或者摇动，或者故意向后移动，上下移动等等，总之采用幽默，ＳＩＬＬＹ的方式，没有小孩不喜欢的。当他的ＡＦＦＥＣＴ给带动起来后，他更能够有主动的欲望跟你交流或者维持跟你的交流。就这个吃饭要移动椅子就可以做不下２０－３０个回合的。同时方位词，大小，宽窄，程度概念等等认知的引入，而且语言训练里面的ＳＣＡＮＦＯＬＤＩＮＧ和示范，模仿等等都能够融合在一起。地板时光中间说的语言训练其实跟其它地方谈的语言训练就是要孩子是用“心”在说话，因为他有动机，所以是在用“心”在说话，而不是简单的ＣＯＰＹ（模仿）了。

总之，抓住感兴趣的东西来教来扩展，他就有动力。当兴趣点越来越多时，你就会更容易带动他，让他觉得跟人玩很有意义了。同时在平时的训练中，也要留一定时间给孩子，给他能够主动发起交流的机会（ＩＮＩＴＩＡＴＩＯＮ）。他的主动性出来了才能推动他自己往前走，去探索。

kwenma2

Stanley I. Greenspan, M.D.
Serena Wieder, Ph.D.

MOBILIZING EACH OF THE SIX FUNCTIONAL DEVELOPMENTAL LEVELS

I. Shared Attention
A. Use the child’s individual sensory and motor profile to draw him into shared attention (e.g., more visual experiences for the child who especially enjoys looking).
B. Harness all the available senses, as well as motor capacities and affects (e.g., involve the child in interactions that involve vision, hearing, touch, and movement, coupled with highly enjoyable activities).
C. Use both constructive and playfully obstructive strategies (e.g., dance or run together with the active child; build a fence with your arms around the child who likes to avoid or run away).
D. Stretch the child’s capacity for shared attention by increasing the interactive circles of communication rather than trying to get the child to focus on a particular object or toy.

II. Engagement
A. Follow the child’s lead in order to engage in interactions that bring him please and joy.
B. Build on these pleasurable and enjoyable interactions.
C. Join in the child’s rhythm in terms of affect, visual, auditory/vocal, and motor movements.
D. Join with physical objects of the child’s pleasure (e.g., put the car he is fascinated with on your head and let him roll it on your head as though it were a mountain).
E. Attempt to deepen the warmth and pleasure by giving priority to his comfort and closeness (allow him to lie on you or cuddle or rock with you or stroke your hair for long periods of time).
F. If necessary, use a little bit of playful obstruction to entice him to focus on you. (Engagement involves a range of emotions, from pleasure and warmth to annoyance and assertiveness.)

III. Two-way, purposeful interactions with gestures
A. Be very animated and attempt to exchange subtle facial expressions, sounds, and other gestures (i.e., entice her into a rapid back-and-forth rhythm).
B. Go for the “gleam in her eye” (i.e., entice her with your animated exchanges into an alert, aware, involved back-and-for pattern).
C. Open and close circles of communication by building on her natural interests, inspiring her to respond to what you do. Keep it going as long as you can.
D. Treat everything she does as purposeful, in order to harness circles of communication (flapping hands could be the basis for an interactive flay-your-hands dance or for a game of waving at each other).
E. Encourage initiative by avoiding doing things for him or to him.
F. Support initiative by challenging him to do things to you (e.g., when roughhousing, get him to jump on you or push you down or climb up to your shoulders, rather than simply picking him up and swinging him or doing other things that may be fun, but do not support his initiative).
G. Help hi go in the direction he wants to by initially making his goal easier to achieve, such as moving the desired ball closer to him.
H. Help him be purposeful by creating a goal where none may appear to exist (e.g. he is moving his car around in a back-and-forth motion and you might stand behind the schoolhouse and claim to need a delivery).
I. Over time, build obstacles between him and his desired goal to increase the number of circles of communication (block his access to the door or turn the door knob the wrong way).
J. As needed, be playfully obstructive (build fences around him if he is aimless; get between him and his goals when he is repetitive or perseverative (e.g., get stuck behind the door he’s opening and closing.

IV. Two-way, purposeful problem-solving interactions
A. Extend circles of communication by creating extra steps (e.g., play dumb so he has to show you how to open the door; when she is moving the car to the school, you exclaim and gesture that you first need a delivery at the hospital).
B. Extend circles of communication by being playfully obstructive and creating interesting barriers or obstacles to his goals.  
C. Work up to a continuous flow of circles (e.g., some children will gradually go from three circles to five to ten, etc,; others will get into a continuous flow of thirty plus circles quickly).
D. Challenge her to close circles of communication (e.g., the child is moving her car but ignores your desire t have your dolly go for a ride in it. You block her car with your hand while you gesture in an animated fashion for her to give the dolly a ride.).
E. Combine affect with action and interaction (i.e., always be animated and show affect through voice and facial expressions while creating interactions).
F. Increase the interactive range, including affects and emotions (e.g., child is just hugging dolls and the wolf comes to make trouble, so the child becomes challenged t o knock the wolf away and increase assertiveness).
G. Increase interactive range in different processing areas, including:
1. Visual/spatial (e.g., chase, hide-and-seek, treasure hunt games)
2. Motor planning and sequencing (e.g., obstacle courses, search games, child has to use two or three steps to open the latch to find the cookie). Perceptual motor (e.g., looking/doing interactions such as rolling, throwing, and/or kicking Nerf balls back and forth, reaching for desired objects on a moving string (while crossing the midline)).
3. Auditory processing and language (using sounds and, when possible, words to communicate (e.g., use animated, compelling vocal tones to draw child’s attention or to communicate (e.g. use animated compelling vocal tones to draw child’s attention or to indicate safety, danger, approval, disapproval, or excitement)).
4. Imitation (draw child into copycat interactions where child is shown how to reach for or get something he wants or to make a sound that will get him something he wants).

V. Elaborating ideas
A. Encourage the use of ideas in both imaginative play (e.g., hugging the dolls) and realistic verbal interactions (e.g., “open” door).
B. Use ideas off of affect or intent (i.e., “want juice!” rather than labeling juice in a picture).
C. W(ords)A(ffect)A(ction) – Always combine words or ideas together with affect and action.
D. Chit-chat using words all the time.
E. Encourage imagination through using familiar interactions for pretend play (e.g., feeding, hugging, or kissing dolls).
F. Jump into a drama that your child has begun. Become a character and ham it up. Communicate mostly as the character, rather than as yourself.
G. Alternate between being a character in a drama of your child’s choosing and a narrator or sideline commentator.
H. Periodically, summarize and encourage your child to move the drama along with a question or challenge.
I. Entice your child into long dialogues.
J. Create challenges where ideas or words are necessary (e.g., “up” because the needed action figure is up on the shelf). Keep extending the dialogue.
K. Encourage the use of all types of ideas (symbolic expression) (e.g., pictures, signs, complex spatial designs (building a city), and acting out roles oneself).


VI. Building bridges between ideas (emotional thinking)
A. Close all symbolic circles in both pretend play and reality-based dialogues (e.g. challenge the child always to respond to what you are saying and doing, just as you respond to what she is saying and doing).
B. Challenge the child to connect different ideas or subplots in a drama.
C. Whenever the child seems confused, brings in something from left field, or seems fragmented or piecemeal in her thinking, challenge her to make sense and be logical. Do not supply the missing pieces of logic (e.g., “I’m confused. We were having a tea party and now we’re flying to the moon?
What happened?”)
D. Be patient and summarize the confusing elements. If the child is not able to build bridges between his own ideas, provide some multiple choice possibilities. Avoid supplying the answer or taking control of the discussion.
E. Challenge with “w” questions, including “what” “where” ‘when” “who” and “why.”
F. When the child ignores or avoids responding to “w” questions, such as “what did you like at school today?” through out some silly possibilities to get the child thinking (e.g., “Did the elephant visit your class today?” or “Did you see your boyfriend (or girlfriend) in class?”)
G. Explore reasons for actions or feelings (e.g., “Why are you attacking me?”).
H. Use multiple choice as needed, always putting the likely answer first and the unlikely one second.
I. Have your character in the pretend play create unexpected situations to challenge the child towards creativity and new solutions. Use humor, conflict, and novelty.
J. Challenge the child t broaden the emotional range in the dramas (e.g., so that it includes caring as well as assertiveness and aggressions).
K. Encourage reflection on feelings in both pretend dramas and reality discussions (e.g., “why do you want to go outside?” or “what’s the reason for the attack?”)
L. Gradually increase the complexity of reflective thinking (e.g., challenge child to give different reasons or motives for actions or consider different views – “How does Sally feel after Mary took her toy” and “How does Mary feel?”)
M. Challenge child to give opinions rather than facts (e.g., ‘what color do you like best and why?” rather than “which color is this?”)
N. Enjoy debates and negotiations, rather than simply stating rules (except where the rule is absolutely essential).
O. Encourage choices and discussions of choices.
P. Encourage and challenge the child into the back-and-forth use of words, instead of focusing on correct grammar.
Q. Increase spatial thinking (e.g., treasure hunt games, junior architect games – lay out a whole city for the action figure drama, etc.).
R. Encourage motor planning and sequencing capacities (e.g., draw diagrams for a tea party or house decorations or attack strategies for space wars, etc.).
S. Encourage understanding and mastering concepts of time by challenging the child to use the past, present, and future (e.g., “What are the space monsters going to do tomorrow?” or “Yesterday we went to the zoo. What would you like to do tomorrow?”)
T. Encourage understanding and use of quantity concepts (e.g., how many cookies should each doll at the tea party have?).
U. Pre-academic or early academic work, complex problem-solving, and social skills should be based on providing an understanding of basic concepts (i.e., connecting ideas) through emotional interactions.
For example:
1. In math, negotiate using candies, cookies, or coins to learn adding or subtracting. Keep the numbers small to avoid rote memory. Eventually work on visualizing the objects and doing the calculations using images.
2. In reading, visualize or picture what is being read (whether the parent or child reads it) and then pretend it out and/or discuss it. Embellish the ideas further.
3. In writing, initially use flexible spelling and word choice and focus on interactive, creative stories and communicating needs or opinions. Later, work on correct spelling, etc.
4. For problem-solving and social skills, work on anticipating by visualizing what may happen later or tomorrow, including positive and negative situations. “Picture” the situations, feelings involved, typical solutions, and alternative ones.
V. In both pretend and reality-based conversations, challenge towards higher levels of abstraction by shifting back and forth between the details (the trees) and the big picture (the forest). For example, periodically wonder how all the things the child has been talking about fit together.
W. Gradually expand the child’s range of experiences (without overload or over-stimulation) because emotionally-based experiences are the basis for creative, logical, and abstract thought.
X. Challenge the child to symbolize auditory, visual-spatial, tactile, motor planning and affective capacities together (e.g., building a city [visual-spatial, motor planning, tactile] with different dramas being acted out [auditory-verbal, thematic, imaginative] involves creative, affective interests being
played out in a pattern of integrated thinking).
VII. Tailor your interactions to the child’s individual differences in auditory
processing, visual/spatial processing, motor planning and sequencing, and
sensory modulation.
A. Profile the child’s individual differences based on observation and history.
B. Work with the individual differences. Utilize natural strengths for interaction (e.g., visual experiences for the child with relatively strong visual/spatial capacities). Gradually remediate vulnerabilities (extra practice for listening to and using sounds and words for the child who has a receptive language or auditory processing challenge; extra soothing for the sensory-over reactive
child; and/or extra compelling and animated for the sensory-under active child).
VIII. Simultaneously attempt to mobilize the six functional emotional
developmental levels (attention, engagement, gestures, complex preverbal problem-solving, using ideas, and connecting ideas for thinking). For the younger child or child with developmental challenges, the later levels will be mastered as the child develops. (See Greenspan and Wieder, The Child with Special Needs.)